Should We Prescribe DAPT for Patients with Recent ACS Undergoing CABG?

A new randomized trial suggests the answer is no.

Dual antiplatelet therapy (DAPT) is standard of care in patients with an acute coronary syndrome (ACS) who are treated with percutaneous coronary intervention (PCI) or medical therapy. Societal guidelines also recommend DAPT for patients who undergo coronary artery bypass grafting (CABG), but the evidence is less clear, and most patients continue to receive only single antiplatelet therapy (mainly aspirin) in this setting.

To address this gap in knowledge and care, investigators randomized 2200 patients undergoing CABG within 6 weeks of an ACS to open-label DAPT with ticagrelor (90 mg twice daily) plus low-dose aspirin or low-dose aspirin alone.

Key Findings:

At 12-month follow-up, there was no difference in the incidence of the primary endpoi…

Reviewing Author

David J. Cohen, MD, MSc

Disclosures

Consultant/Advisory BoardMedtronic; Edwards Lifesciences; Abbott Vascular; Boston Scientific; St. Francis Hospital

Speaker’s BureauBoston Scientific; ZOLL Medical

Grant/Research SupportEdwards Lifesciences; Abbott Vascular; Boston Scientific; Corvia Medical; National Heart, Lung, and Blood Institute; Phillips, Inc.; St. Paul’s Hospital; V-Wave, Inc; ZOLL Medical; CathWorks, ANCORA

Editorial BoardsJACC; American Heart Journal; EuroIntervention; JSCAI; Structural Heart Journal

Leadership Positions in Professional SocietiesSociety of Thoracic Surgeons/American College of Cardiology TVT Registry (Co-Chair, Risk Model Development Committee); Cardiovascular Research Foundation (Co-Director, TCT Annual Meeting; Co-Director, New York Valves Annual Meeting)